A Study on Establishing a "Critical State" Early Warning Score After Congenital Heart Disease Surgery and an Integrated Treatment Model of a Multidisciplinary Rapid Response Team
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Congenital Heart Disease
- Sponsor
- Chinese Academy of Medical Sciences, Fuwai Hospital
- Enrollment
- 4115
- Locations
- 1
- Primary Endpoint
- event occurrence-an inclusion of composite clinical diagnose
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
By establishing a warning scoring tool for the early "critical state" after congenital heart disease surgery, the multidisciplinary rapid response team is proactively activated, forming an integrated treatment model of early warning-team decision-making-organ assistance.
Detailed Description
All children aged 0-14 years admitted to the PICU from 2021-2022 were enrolled continuously, and their baseline data such as gender, age, RACHS-1 score, cardiopulmonary bypass time, aortic clamping time, whether there was chromosomal lesions, whether there was preoperative endotracheal intubation/heart failure, changes in oxygenation index, lactate, and vasoactive drug scores were obtained. All variables that may lead to composite malignant events including death in the early postoperative period were included, including death, pulmonary hypertension crisis, malignant arrhythmias (supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, high-degree atrioventricular block) requiring antiarrhythmic drugs or pacemaker treatment, cardiopulmonary resuscitation, ECPR, emergency sternal expansion, severe AKI, severe ARDS, neurological complications (cerebral hemorrhage, cerebral infarction), gastrointestinal complications (gastrointestinal bleeding, intestinal obstruction, intestinal necrosis).The variables were included in the machine learning analysis to establish the model.
Investigators
Xu Wang
Chief Physician
Chinese Academy of Medical Sciences, Fuwai Hospital
Eligibility Criteria
Inclusion Criteria
- •pediatrics admitted to ICU
Exclusion Criteria
- •surgery without cardiopulmonary bypass
- •using extra-corporeal circulation during surgery
- •Delayed chest closing during surgery
Outcomes
Primary Outcomes
event occurrence-an inclusion of composite clinical diagnose
Time Frame: Within 48 hours after surgery
critical status included clinical diagnose：arrhythmia（ventricular tachycardia、ventricular fibrillation、refractory supraventricular tachycardia ）,prognosis（death or live）,bedside thoracotomy,CPR,ECMO,extracorporeal circulation establishment,renal replacement therapy,peritoneal dialysis, hemofiltration. If one of the above diagnosis and treatment used in patients, they would be divided to case group.